Provider Demographics
NPI:1053854505
Name:MILTON, WALTER JR (BA)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:MILTON
Suffix:JR
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 READ BLVD
Mailing Address - Street 2:SUITE 740
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3140
Mailing Address - Country:US
Mailing Address - Phone:504-245-2440
Mailing Address - Fax:504-245-4284
Practice Address - Street 1:1448 FILMORE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-1957
Practice Address - Country:US
Practice Address - Phone:504-638-6278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor